Case Report
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World J Gastrointest Endosc. Dec 16, 2010; 2(12): 408-412
Published online Dec 16, 2010. doi: 10.4253/wjge.v2.i12.408
Successful type-oriented endoscopic resection for gastric carcinoid tumors: A case report
Shouji Shimoyama, Mitsuhiro Fujishiro, Yutaka Takazawa
Shouji Shimoyama, Gastrointestinal Unit, Settlement Clinic, Tokyo 120-0003, Japan
Mitsuhiro Fujishiro, Department of Internal Medicine, Tokyo University, Tokyo 113-8655, Japan
Yutaka Takazawa, Department of Pathology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
Author contributions: Shimoyama S managed the patient and prepared the manuscript; Fujishiro M treated the patient; and Takazawa Y contributed with the pathology.
Correspondence to: Shouji Shimoyama, MD, Gastrointestinal Unit, Settlement Clinic., 4-20-7, Towa, Adachi-ku, Tokyo 1200003, Japan.
Telephone: +81-3-36057747 Fax: +81-3-36050244
Received: August 14, 2010
Revised: October 28, 2010
Accepted: November 4, 2010
Published online: December 16, 2010

The standard treatment in Japan for gastric carcinoid has been gastrectomy with lymphadenectomy. This report describes the possibility of endoscopic treatment as an appropriate option for gastric carcinoid fulfilling certain conditions. A 46 year old woman underwent endoscopic mucosal resection for two 3 mm gastric carcinoids. The patient had hypergastrinemia with pernicious anemia and type A chronic atrophic gastritis, suggesting that the tumors were type I in Rindi's classification. Both tumors were located in the mucosal layer with no cellular polymorphism and were chromogranin A positive. Neither tumor recurrence in the stomach nor distant metastases have been documented during the 5 years of follow-up. Although many type I gastric carcinoids may be clinically indolent, reports on successful endoscopic treatment for this carcinoid have been scanty in the literature in Japan, presumably because of the hitherto surgical treatment stance for the disease. This report discusses how the size, number, depth and histological grading of the type I gastric carcinoid could allow the correct identification of a benign or malignant propensity of an individual tumor and how endoscopic resection could be a treatment of choice when these factors render it feasible. This stance could also obviate unnecessary surgical resection for more benign tumors.

Keywords: : Endoscopic resection, Gastric carcinoid, Hypergastrinemia, Pernicious anemia, Type A chronic atrophic gastritis.